Document Detail

Sirolimus versus bare metal stent implantation in patients with total coronary occlusions: subgroup analysis of the Stenting Coronary Arteries in Non-Stress/Benestent Disease (SCANDSTENT) trial.
MedLine Citation:
PMID:  17070149     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Coronary restenosis is more common in a total coronary occlusion (TCO) than other lesion types after implantation of bare metal stents (BMS). But whereas sirolimus-eluting stents (SES) have been shown to improve the outcomes in simple coronary artery lesions, data on their efficacy in complex coronary lesions are scarce. METHODS: We enrolled 127 patients with coronary artery disease and a TCO > or = 15 mm in length to have either SES or BMS implanted after successful recanalization. Outcome measures included the minimal lumen diameter, the late lumen loss, and angiographic restenosis (> 50% diameter stenosis) at 6 months follow-up and the occurrence of target vessel failure during a 7-month period. RESULTS: The patients were well matched in demographic and angiographic baseline characteristics, and 20% had diabetes. The reference vessel was 2.92 mm in mean, and the lesion length was 25.2 mm. At follow-up, patients who received SES had a minimal lumen diameter of 2.49 mm compared with 1.46 mm in those who received BMS (P = .015), 0% versus 38% developed restenosis (P < .001), lumen loss was -0.05 versus 0.99 mm (P < .001), and the target vessel failure rate 5% with SES versus 35% with BMS (P < .001). Stent thrombosis occurred in 1 patient in the BMS group. CONCLUSIONS: Implantation of SES is safe, and it markedly reduces angiographic restenosis and the occurrence of adverse events in patients with a TCO.
Henning Kelbaek; Steffen Helqvist; Leif Thuesen; Lene Kløvgaard; Erik Jørgensen; Kari Saunamäki; Lars R Krusell; Hans E Bøtker; Thomas Engstrøm; Gunnar V H Jensen;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  152     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-30     Completed Date:  2006-11-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  882-6     Citation Subset:  AIM; IM    
Cardiac Cath.Lab., Rigshospitalet, Copenhagen, Denmark.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Blood Vessel Prosthesis Implantation
Coronary Artery Disease / therapy*
Coronary Restenosis / prevention & control*
Drug Administration Routes
Drug Delivery Systems
Immunosuppressive Agents / administration & dosage*
Middle Aged
Randomized Controlled Trials as Topic
Sirolimus / administration & dosage*
Reg. No./Substance:
0/Immunosuppressive Agents; 53123-88-9/Sirolimus
Comment In:
Am Heart J. 2006 Nov;152(5):807-9   [PMID:  17070136 ]

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